A STUDY ON ISLAMIC PSYCHO-SPIRITUAL THERAPY ON RECOVERED ADOLESCENT ADDICTS
Nik Ahmad Hisham Ismail IIUM, Kuala Lumpur, Malaysia Email: [email protected]
Ridwan Haris
Universitas Al Azhar Indonesia, Jakarta, Indonesia Email: [email protected]
Siti Kholijah Kassim IIUM, Kuala Lumpur, Malaysia Email: [email protected]
Muhamad Zahiri Awang Mat
Universiti Perguruan Ugama Seri Begawan, Brunei Darussalam Email: [email protected]
Abstract
Therapeutic intervention on drug addiction with a spirituality approach is interesting to pursue since many studies have produced various results. The focus of this study is on psycho-spiritual problems on individuals who had experienced drug addiction. The problems are loss of awareness and mind, physical and mental weakness, anti-social behaviors and problems in the school. Thus, a more in-depth study of the role of spirituality on this problem in increasing mentality, conscious mind and behaviors as a normal personality.
To accomplish this, the researchers explored four individuals who had recovered from an addiction and had undergone Islamic therapeutic intervention at Inabah Centre in Tasikmalaya and Madani Health Care in Jakarta, Indonesia. The findings revealed that they gained enlightenment and consciousness, were reflective and regretful, had self-confidence and were persistent in doing good deeds after going through the recovery process. All aspects of the findings were generated into four themes, namely reflection feeling (RF), insight awareness (IA), expression attitude (EA), and brightness image (BI). Some aspects of psycho-spiritual from Islamic perspective were also explained in the discussion to make it a valuable force in preventing, treating and handling the addiction in society.
Keywords: Addiction, Islamic Therapy, Spirituality, Adolescence, Qualitative Method.
Jurnal Pendidikan Agama Islam / Journal of Islamic Education
pISSN: 2339-1332, eISSN: 2477-0027 Volume 10, Number 2, December 2022 DOI: https://doi.org/10.21093/sy.v10i2.5653
A. Introduction
This study is an attempt to understand the issue of drug abuse and treatment as an array of dynamic interaction between religious, spiritual, psychological, social and medical approaches. In this study, the religion-spiritual approach attained increase success treatment for drug addicts. In an investigation on spirituality, it has been suggested that religious beliefs and behavior play a significant role in the promotion of positive adjustment among individuals, especially through reductions of risk behavior.1 Furthermore, religious adolescents are considered less likely to display delinquent behavior. Use drugs and alcohol2 and engage in premarital sexual activity.3 More work to be conducted to explore different treatment modalities that can provide suitable and acceptable approaches and techniques for drugs abuse rehabilitation.
This study intents to provide some understanding to the therapeutic community modality based on Islamic teachings and values that are commendable to Muslim society in Indonesia. However, as in many other studies, outside the secular- western theoretical framework, this study encountered some problems especially in establishing variables in the initial stage of the study. Kagawa et al, speculate that a study on spirituality and adolescent behavior is challenging in the initial stage since there were no exact variables within religion-spiritual domains to be studied because they tend to be conceptualized and measured inconsistently across studies and different situations. For instance, some studies assess spirituality by frequency of attendance at religious services, internal religious devotion and spirituality routines such as personal importance of one’s religious beliefs, private Holy Book reading, prayer, congregational religious activities, and other studies use the report of religious attendance alone to assess spirituality.45 Therefore, there is a need to study therapeutic modality for example psychotherapy inclusive of Islamic religious teaching and values.
Indeed, the role of Islamic teaching and values for individual well-being has not been widely explored in the literature yet. There were few studies that enhanced Islamic teaching and well-being mentioned in the literature as Islamic spirituality. The researchers found several studies such as Islamic spirituality and mental health6, role
1 Christopher J. Holmes and Jungmeen Kim-Spoon, “Positive and Negative Associations between Adolescents’ Religiousness and Health Behaviors via Self-Regulation,” Religion, Brain & Behavior 6, no. 3 (July 2, 2016): 188–206, https://doi.org/10.1080/2153599X.2015.1029513.
2 Brian J. Grim and Melissa E. Grim, “Belief, Behavior, and Belonging: How Faith Is Indispensable in Preventing and Recovering from Substance Abuse,” Journal of Religion and Health 58, no. 5 (October 1, 2019):
1713–50, https://doi.org/10.1007/s10943-019-00876-w.
3 George M. Hayward, “Religiosity and Premarital Sexual Behaviors Among Adolescents: An Analysis of Functional Form,” Journal for the Scientific Study of Religion 58, no. 2 (2019): 439–58, https://doi.org/10.1111/jssr.12588.
4 Rubeena Kidwai et al., “The Effect of Spirituality and Religious Attendance on the Relationship between Psychological Distress and Negative Life Events,” Social Psychiatry and Psychiatric Epidemiology 49, no. 3 (March 1, 2014): 487–97, https://doi.org/10.1007/s00127-013-0723-x.
5 M. Kagawa Singer et al., “Culture: The Missing Link in Health Research,” Social Science & Medicine 170 (December 1, 2016): 237–46, https://doi.org/10.1016/j.socscimed.2016.07.015.
6 Yalnaaz Lakdawala, Aqsa Qasmi, and Cicilia Chettiar, “Relationship between Islamic Spirituality and Psychological Well-Being, Depression and Anxiety,” Indian Journal of Mental Health(IJMH) 5, no. 1 (January 16, 2018): 114, https://doi.org/10.30877/IJMH.5.1.2018.114-118.
of Islam in mental health and psychopathology7, Islamic based intervention for mental health and depression, Islamic spirituality and delinquency and Islamic spirituality and commitment. These complementary studies shown scientific evidences to ameliorate the roles of Islamic teachings and spirituality on issues of the mental health, interventions and treatment. As intended this study is an effort to explore Islamic teaching and spirituality that help drug addicts who undergone intervention and treatment in Islamic psycho-therapy. This research seeks to find evidences from case studies to uncover the psycho-spiritual aspect of drug users who are undergoing treatment in the rehabilitation center.
Islamic teaching and values are importance for good mental and psychological well-being. In Islam, there are two major sources for a Muslim namely the Quran and the Sunnah. As mentioned by many Islamic scholars such as Al Ghazali, Ibn Sina, Al Farabi and many others, Al-Quran and Sunnah of the prophet are life-long guidance for every Muslim. Thusly, The Al-Quran and the Sunnah are momentous guide to Muslim who are suffering from emotional distress and leading toward meaningful quality of life. Abu Hurairah narrated in a Hadith (Sahih Al Bukhari) “There is no disease that Allah has created except that He also has created its treatment.
“Furthermore, Samah says that Al-Quran gives Muslim guidance to help overcome the inner turmoil and bring peaceful and tranquility to oneself. In addition, Al-Quran emphasizes on a mental state of awareness and focus on happiness also known as Mindfulness. A mindful person can become aware of one’s being, emotions, feelings and actions that forever strive for mercy of Allah. Highlight complementary aspects between Islamic teaching or education and psychotherapy as Islamic principles and values can provide a source of meaning, purpose and moral guidance that complement and enrich psycho-therapy; and, Islamic education can provide a framework for understanding the spiritual dimensions of psychology such as the nature of soul, the purpose of suffering, and the role of gratitude and patience in achieving inner peace as part of the psycho-therapy interventions and treatment.
B. Literature Review Theoretical Framework
Mueller (1980) mention pioneer social psychologists such as Hall (1891), Starbuck (1899) Leuba (1912) and Glock (1962) have generally recognized the distinctions between spiritual beliefs as cognition domain, spiritual feelings affective domain and spiritual works or practices as behaviour domain. In brief, the cognitive component of belief is also referred to as “ideological” dimension. The affective component is the feeling dimension and encompasses feelings toward religious beings, objects or institutions. The behavioural component of spirituality is “acted out”, such as in activities like ritual attendance, financial contributions, frequency of personal prayer and scripture study, and ethical behaviours.
From the Islamic perspective, spirituality has been established early on, the concept of spirituality is realizing human nature and also showing the quality of
7 Walaa M. Sabry and Adarsh Vohra, “Role of Islam in the Management of Psychiatric Disorders,” Indian Journal of Psychiatry 55, no. Suppl 2 (January 2013): S205, https://doi.org/10.4103/0019-5545.105534.
human life in society. The relationship between divinity and humanity is running in tandem and cannot be separated. The Prophet Muhammad (pbuh) said narrated by Abu Hurairah which means, “The best among you is who have the best characters” (At- Tarmizi). Again, the concepts of spirituality in Islam include beliefs, ritual and social activities, for example tauheed, aqidah, ibadah, and syariah and mu’amalah. These concepts are interrelated and it is the goal of human life to be servant of God (Ibadullah). In fact, Islamic spirituality has a great impact in building character, personality and morality in the Muslim society (see Fig. 1). This spirituality consists of beliefs and thoughts (aqidah), practices (ibadah) as well as morality (akhlak). All categories of spirituality are associated with character building that is eliminating bad habits, increasing self- confidence, and allowing for insight strength to change life in accordance with good spiritual practice in the community. Spiritual beliefs are related to the cognitive domain, while spiritual practice is related to the affective domain and morality spirituality is associated with the psycho-motor domain.
Figure 1. The Islamic Spirituality Aspect and Therapy
Hence, this study aims to investigate the students’ perceptions towards spirituality to the following questions:
1. In what way does Islamic psycho-spirituality help relieve the addiction?
Physical dimension
• Biological changes
• Intellectual decline
Psychological dimension
• Emotional emerges
• Personality disorder
Mental dimension
• Character back down
• Anti-Social
Spiritual dimension
• Belief weakness
• Ritual neglect
Drug Abuse
Drug Addiction Therapy/Healing
Islamic Psycho-Spiritual Therapy;
Spiritual dimension, mental dimension, psychological dimension and physical dimension
Relapses Abstention
2. What are the Islamic psycho-spiritual factors that contributed to the recovering process of addiction?
3. What are the roles of Islamic Spiritual therapy in the recovery process of addiction?
Previous Studies
This study reviews both Western and Islamic perspectives about providing help for mental health problems in the context of spirituality dimensions on adolescent drug addicts. The importance of the spirituality on mental health research is emphasised in this study, with examples of the influence of spirituality on symptoms of mental health problems, such as drug addiction, depression and anxiety.
All theorists in addiction unanimously agree that the notion of addiction is an extremely complex one. Its complexity derives in part from the psychological, social and biological impacts it has on the individual user, and in part from its effects on society, law, economics and politics. Consequently, drug addiction has been portrayed alternatively as a disease, behaviour or in religious discourse, a sin. This literature intends to address the question of how drug addiction attaches itself to adolescent lives within their transitions development and how to overcome this situation from both, Islamic and Western perspectives. In this study, several key themes will be illustrated including terms of addiction, substance use characteristics, therapy intervention, and spirituality approach.
In the history of addiction research, various theories and models of addiction have been proposed. The most prominent explanatory models include: (1) social/environment models in which many models of substance abuse have been criticized for failing to attend sufficiently to social and contextual factors; (2) genetic/physiological models which suggest that substance abuse with chemical dependence runs in families and that it may be transmitted across generations; (3) personality/intra-psychic models links personality intrapsychic dysfunction and inadequate psychological development to juvenile delinquency and antisocial behaviour disorders, including drug addiction; (4) coping/social learning models associates drug abuse with inadequate coping skills and critical personality deficits; (5) conditioning/reinforcement behavioural models focus on the direct effects of addictive behaviour, such as tolerance, withdrawal, other physiological responses and rewards; (6) compulsive/excessive behaviour models conceptualize addiction as due to “excessive appetites.”; (7) integrative bio-psychosocial model indicates the integration of biological, psychological and sociological explanations that are crucial for understanding substance abuse; and 8) trans-theoretical model of change which offers an integrative framework for understanding and intervening with human intentional behaviour change.
There are four approaches to treat mental illness.8 First, Pharmacotherapy in which medications are now used widely as primary or adjunctive interventions to treat
8 Antoine B. Douaihy, Thomas M. Kelly, and Carl Sullivan, “Medications for Substance Use Disorders,”
Social Work in Public Health 28, no. 3–4 (May 1, 2013): 264–78, https://doi.org/10.1080/19371918.2013.759031;
Mutsuhiro Nakao, Kentaro Shirotsuki, and Nagisa Sugaya, “Cognitive–Behavioral Therapy for Management of
mental illness (e.g., alcoholism and drug abuse, anxiety, depression, etc.). In fact, these include medications to reduce cravings to use drugs, to reduce the reinforcing effects of the psychoactive substances, to make taking drugs aversive, and to treat co- occurring mental disorders that may potentially underlie the drinking or drug use.
Antidepressant medications have also been used to treat alcohol-dependent individuals with co-occurring depression. Second, Psychosocial Interventions such as in the case of a drug addict, is a commonly used formal treatment approach, derived from AA and the disease model, that is the twelve-step facilitation (TSF). In TSF, substance dependence is viewed not as symptomatic of another illness, but as a primary problem with biological, emotional, and spiritual underpinnings and presenting features. The primary goals of treatment are to encourage clients to work through their denial and work the 12 steps of AA. Third, Cognitive and Behavioural Therapy (CBT) of which the technique teaches clients coping skills to reduce or eliminate mental health problems through instruction and rehearsal strategies for coping with situations, self-monitoring and behavioural analysis, strategies for recognizing and coping with cravings, coping with lapses and instruction on problem solving. Finally, is Motivational Enhancement Therapy (MET) whereby treatment intervention, which has grown out of observation, attempts to get clients to assume responsibility for helping themselves and increasing their desire to change through a technique referred to as motivational interviewing. Motivational interviewing is defined as a directive, client-centred therapy style designed to elicit change by assisting clients with exploring and resolving ambivalence. Exploring ambivalence about change is the central goal of motivational interviewing with therapists acting as the directive in pursuing this objective.9
Interestingly, the concept of consciousness from Western and Islam views is different. The Freudian psychoanalysis defines consciousness as descriptive and past- oriented, whereas Islamic therapy is prescriptive and further oriented. The therapeutic principle of Islamic psychology seeks to change the patient’s future behaviour by sensitizing his/her conscience and making him/her responsible to God. Western therapy on the other hand, desensitizes the human conscience because based on religion, it is devoid of ethics. It is therefore not surprising that it treats the psychological symptoms of spiritual diseases through medication but at the same time, fails to treat the causes of those diseases.10 The overall benefits of spirituality have recently found greater presence in the literature. However, studies regarding spirituality in the field of addiction are still underrepresented. Spirituality is one of the essential foundations for the remediation of an addictive disease, yet many treatment
Mental Health and Stress-Related Disorders: Recent Advances in Techniques and Technologies,” BioPsychoSocial Medicine 15, no. 1 (October 3, 2021): 16, https://doi.org/10.1186/s13030-021-00219-w; Oluwafikayomi Opeyemi Banjo and Kehinde Oluwaseun Kester, “Motivational Enhancement Therapy (MET) on cannabis abstinence amongst undergraduates in two private universities in southwestern Nigeria,” Journal of Humanities Therapy 12, no. 1 (June 2021): 59–81, https://doi.org/10.33252/jht.2021.06.12.1.59.
9 Meredith Kells et al., “Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care,” Journal of Pediatric Nursing: Nursing Care of Children and Families 49 (November 1, 2019): 24–30, https://doi.org/10.1016/j.pedn.2019.08.011.
10 Khalidah Khalid Ali and Muhaimin bin Sulam, “The Paradigms of Consciousness: A Discourse,” SHS Web of Conferences 53 (2018): 04003, https://doi.org/10.1051/shsconf/20185304003.
programmes steer clear of addressing this human dimension. Fears of crossing ethical boundaries, feelings of inadequacy due to lack of training, amongst others, are understandable. If a patient finds hope and support in a spiritual practice, the provider should have the skills to not only encourage the patient but to assist in further developing spiritual growth, regardless of what personal beliefs the counsellor may have. With proper training, ambiguity and self-doubting should decrease.
According to Khalid, a drug addict gets involved in drug abuse simply because he does not have a strong spiritual life, therefore, a strong spiritual life not only can prevent someone from being involved in drug abuse but also can give effective treatment to drug addicts.11 His paper is mainly substantiated by the outcome of reliable field research done in Pondok Remaja Inabah, both in Indonesia (the centre) and Malaysia (the branch). He mentioned that Islamic spiritual therapy can only come from Islamic spirituality. Moreover psycho-spiritual therapy emphasizes the importance of remembrance of Allah SWT., because only through remembrance of Allah SWT that the self will always be aware and alert about the real purpose of this life. Psycho-spiritual therapy can be regarded as “return to the origin” (God) approach or faith-based therapy. It appears simple but in reality, it needs a lot of sacrifice, patience, sincerity, honesty and clarity about the concept of the purpose of life, the concept of self, the concept of God, the concept of reward and the punishment and the concept of death. Generally, potential drug addicts fail to fight against his commanding self and do not have a clear picture about all these concepts.12
In an article by Adam et al., “Spiritual and Traditional Rehabilitation Modality of Drug Addiction in Malaysia”, they sought to explore the diversity of alternative modalities for rehabilitation process as practiced in Malaysia.13 According to them, the phenomenon of drug addiction is becoming increasingly serious in Malaysia due to the surge in the number of addicts among youths. Despite various efforts by the government for the purpose of treatment or rehabilitation, most are less successful.
Therefore, their study was conducted to explore some spiritual and traditional modalities for drug abuse rehabilitation process in Malaysia. Data was collected using content analysis approach. The findings also show that there are eight spiritual and traditional modalities in Malaysia, namely Raden Suratman’s Traditional and Spiritual Drug Addiction Rehabilitation, Darul Syifa‟s Spiritual Drug Addiction Rehabilitation, Hj. Salleh‟s Traditional and Spiritual Drug Addiction Rehabilitation, Jabat Sufi‟s Private Drug Treatment & Rehabilitation, Christianity Spiritual Drug Addiction Rehabilitation, and Malaysian Association for the Study of Traditional Asian Medicine (MASTAM). Furthermore, they described that rehabilitation centres in Malaysia have provided many facilities to support their rehabilitation programmes including drug detectors, detoxification, provision of rehabilitation orders, military-style training, a
11 Muhammad Yusuf Khalid, “Psycho-Spiritual Therapy Approach,” ANTIDADAH MALAYSIA, n.d., 143–52.
12 Saiful Amri and M Z M Amin, “Model of Psycho Spiritual Therapy Based on Al-Quran and Hadith in the Treatment of Drug Addiction,” 6th International Conference on Quran as Foundation of Civilisation 2015, no.
October (2019): 2–9.
13 Fadzli Adam, Wan Ibrahim, and Wan Ahmad, “Spiritual and Traditional Rehabilitation Modality of Drug Addiction in Malaysia” 1, no. 14 (2011): 175–81.
variety of vocational skills training, counselling, religious classes, civic and polity, agriculture and livestock. Currently, there are fully operational 28 rehabilitation centres in the country. Drugs addicts who undergo rehabilitation process at one of these centres will have to go through four rehabilitation phases which are learning, implementation, self-awareness and integration processes.
Finally, their study concludes that it is not easy to convince the drug addicts that the spirituality treatment approach is very effective, partly because they have a very little religious background if any. Ironically, many practicing Muslims themselves do not believe if there is such a thing called “Islamic spirituality” which can provide treatment for drug addiction effectively. In other words, there has been erosion or crises in faith. Therefore, the present study explores the importance of Islamic spirituality in the therapeutic manner for illnesses, especially on drug addiction.14
As the study of Islamic psycho-spiritual therapy has recently found greater presence in the literature, practitioners should receive training on how to utilize the spiritual dimension in encouraging clients and assisting them for further spiritual growth, regardless of what personal beliefs the counselor may have. Prior to training, a counselor must be aware of the four aspects of spirituality, which are ruh, ‘aql, qalb, or heart, and nafs, or desire15, as these four aspects strongly interact and influence each other, as well as empower individuals to have a sense of control over their behaviors, beliefs, thoughts, and feelings. Thus, the greater the individual's involvement in psycho-spiritual therapy that involves the four aspects of spirituality, the stronger they will be in controlling their behaviors, beliefs, thoughts, and feelings. The application of or involvement in psycho-spiritual therapy is varied according to rehab centers and practitioners.
Mohd Jailani et al. includes three themes in their psycho-spiritual module,
‘Modul Terapi Taubat Terpimpin’, which are: 1) developing divine consciousness; 2) strengthening moral character; and 3) developing personal and social skills. These themes are based on the belief that individuals who are drug addicts need a consistent and committed therapist who will guide them with specific activities that are designed to strengthen their ruh, ‘aql, qalb, and nafs. The activities were designed to achieve the three themes. Developing divine consciousness required participants to absolutely surrender to God through Asmaul Husna, repent and consistently worship God, recognize their own potential and control their own desires, as well as aware of the ultimate consequences of their actions, namely, heaven and hell. Next, strengthening moral character is vital in reshaping one’s character and influencing them to find their own identity, which includes having the Prophet (pbuh) as their idol. Last but not least, to prepare the participants for the reality world outside the rehab centers, practitioners will teach and infuse some personal and social skills, which include coping skills for dealing with society or any unfinished business. In addition to the use of Asmaul Husna, Islamic psycho-spiritual therapy includes the remembrance of
14 Benaouda Bensaid, Salah Ben Tahar Machouche, and Mustafa Tekke, “An Islamic Spiritual Alternative to Addiction Treatment and Recovery,” Al-Jami’ah 69, no. 1 (2021): 127–62, https://doi.org/10.14421/ajis.2021.591.127-162.
15 Muhammad Naquib Al-Attas (Syed), Islam and Secularism (Kuala Lumpur: Hindustan Publications, 1993).
Allah through prayer and zikir.16 A qualitative study by Ahmad Mansor et al. (2018) on Qodiriyah Naqsyabandiyah Zikir Tariqat as a drug recovery treatment in Malaysia revealed that remembrance, or zikir, positively boosts and enhances one's spiritual and mental health and gradually assists participants in recovering entirely from their addictions.
On the other hand, M. Saiful et al. in their qualitative study found out three key ideas of psycho-spiritual therapy, which are: tazkiyah al-nafs (purification of the soul), fundamental religious knowledge (fard ‘ayn), and a therapeutic support system.
From the observations and interviews conducted, these key concepts are bound to help individuals recover from drug addiction, particularly relapsing Muslim addicts.
According to Ibn Qayyim, the soul was created flawed and imperfect, and will only be perfect and flawless with purification, or tazkiyatun nafs.17 Tazkiyah al-nafs, or the purification of the soul, is a process brought by Al-Ghazali to purify the soul from negative traits (mazmumah) that inhibit the development of good morals, values, and behaviors (mahmudah). To purify the soul and indirectly one’s character, there are five primary components that individuals need to consistently commit and improve its quality, which are prayer, fasting, tafakkur, qiyam al-lail, and zikr Allah.18 Next, the study also revealed the essence of fard ‘ayn in enhancing an individual’s resilience. Muslim addicts' real issues are that they have not been adequately taught fard ‘ayn, resulting in their choosing the wrong path. Hence, through re-learning fard ‘ayn, they will be more resistant to vices such as drug use. The last component that is vital to an individual’s recovery is their support system. That focusing on the spiritual aspect only will not help drug addicts in the long term, as they probably will relapse. This is because they are not living by themselves; therefore, there are four entities that play vital roles in encouraging and supporting an individual’s recovery, namely, the institution (the rehab center), the peer group (the inmates or friends in the rehab center), the community (people outside the rehab center), and the mentor (among the management team, or an influencer or individual assigned to be with them at a certain time).
Finally, their study concludes that it is not easy to convince the drug addicts that the spirituality treatment approach is very effective, partly because they have a very little religious background if any. Ironically, many practicing Muslims themselves do not believe if there is such a thing called “Islamic spirituality” which can provide treatment for drug addiction effectively. In other words, there has been erosion or crises in faith. Therefore, the present study explores the importance of Islamic spirituality in the therapeutic manner for illnesses, especially on drug addiction.
16 Khalid, “Psycho-Spiritual Therapy Approach”; Adam, Ibrahim, and Ahmad, “Spiritual and Traditional Rehabilitation Modality of Drug Addiction in Malaysia.”
17 Nur Hadi Ihsan, Munir Munir, and Dedy Irawan, “Tazkiyah Al-Nafs Wa ‘Alāqatuhā Bi al-Sa’Ādah ‘inda Ibn Qayyim al-Jawziyyah,” Kalimah: Jurnal Studi Agama Dan Pemikiran Islam 19, no. 2 (September 8, 2021): 297–
318, https://doi.org/10.21111/klm.v19i2.6629.
18 Nur Zainatul Nadra Zainol et al., “The Propose on Tazkiyah Al-Nafs Approach by Sheikh Said Hawwa for Women Rehabilitation Centre,” International Journal of Academic Research in Business and Social Sciences 11, no. 9 (September 12, 2021): 427–438.
Table 1 illustrates the terms and meanings of addiction characteristics as stated in the National Survey of Drug Use and Health (2002).
Table 1
Summary of the addiction characteristics
Defining the Terms Substance Use, Abuse, Dependence, and Addiction Substance use refers to any use of alcohol; cigarettes or an illegal drug like
marijuana, cocaine or heroin within a specific time frame (e.g., daily, within the last month or within the last year).
Substance abuse refers to use that result in a person:
1. Failing to fulfil major role obligations at school or home.
2. Using substances in situations that are physically hazardous.
3. Experiencing substance-related legal problems.
4. Having persistent social or interpersonal problems.
Dependence involves an ongoing psychological or physical need to use a substance and involves experiencing three or more of the following symptoms in the past year:
1. Tolerance—the requirement to use more of a substance to experience the same effect as experienced when it was used initially.
2. Withdrawal—the physical and psychological effects
experienced when use of a drug is stopped (i.e, depression).
3. Using more for longer periods than intended Addiction refers to use that result in a person :
1. Inability to stop using a drug. This distinction can be difficult to discern, for which the need for increasing dosages can represent tolerance or a worsening underlying problem
2. Desire to, or unsuccessful efforts to, cut down or control dependence use.
3. Considerable time spent in obtaining or using the substance or recovering from its effects.
4. Continued use despite knowledge of problems caused by, or aggravated by, use.
Source: National Survey of Drug Use and Health, 2002 C. Research Method
This research applied the qualitative approach as its primary approach with a case study design. With this approach, the researchers were able to develop a complex, holistic picture, words analyse, and reports detailing views of informants, and conduct the study in a natural setting. Mohajan defines qualitative research as “describe and
interpret issues or phenomena systematically from the point of view”.19 Denzin and Lincoln claim that qualitative research involves an interpretive and naturalistic approach. It means that qualitative researchers study things in their natural settings, with the purpose to make sense, and to understand the phenomena of the meanings people bring to them.
The researchers used qualitative research for a number of reasons. Firstly, the research was concerned with understanding the spirituality and personality phenomenon. Secondly, the researchers pursued an exploratory research based on objective which were not formulated at the start of the research process. Thirdly, this approach allowed for flexibility to follow unexpected ideas during research and explore processes effectively and deeply meaning. Finally, it also allowed the ability to study symbolic dimensions and social meaning to develop empirically supported new ideas and theories.
Furthermore, according to Heale and Twycross, case study is a strategy for doing research which involves an empirical investigation of a particular contemporary phenomenon within its real-life context using multiple sources of evidence.20 Furthermore, a discussion about setting and sites might include for aspects identified below:
1. The place setting: this research was conducted in the Islamic therapeutic intervention at Inabah Centre in Tasikmalaya Indonesia.
2. The event: all participants participated in the interview session and therapy session. The participants are adolescents recovering from drug addiction.
3. The process: the participants are involved in the nature programme of treatment based on Islamic psycho-spiritual therapy.
In order to retrieve data from the participant, this research applied triangulation methods to combine and collect the comprehensive data from participants through interviews questions (in-depth interview, focus group and analysis of documentary).
With the triangulation method of collecting data, especially in-depth interviews, the researchers obtained optimal data set from the informants on their personal histories, perspectives and experiences, particularly when sensitive topics were being explored.
Participants
The participants (interviewees) of the study were purposefully selected among students (patients) at the rehabilitation centre of Inabah Suryalaya Tasikmalaya Indonesia. There were 4 participants comprising students from different regions of Indonesia namely Jakarta, West Java and Central Java. They had undergone the rehabilitation programme for at least 1 year and were placed in the school programme at secondary level. There were 2 males and 2 females, aged above 15 years old, who
19 Haradhan Kumar Mohajan, “Qualitative Research Methodology In Social Sciences And Related Subjects,” Journal of Economic Development, Environment and People 7, no. 1 (March 30, 2018): 23–48, https://doi.org/10.26458/jedep.v7i1.571.
20 Roberta Heale and Alison Twycross, “What Is a Case Study?,” Evidence-Based Nursing 21, no. 1 (January 1, 2018): 7–8, https://doi.org/10.1136/eb-2017-102845.
had been involved in ‘drugs’ for 1 year, and had recovered from drug addiction for approximately 2 months.
Data collection instrument
A semi-structured interview schedule consisting of nine (9) open-ended questions was designed by the researchers in the light of a comprehensive literature review. The content of the interview questions was built around the three specific research questions. The first until third interview questions were about understanding, practicing, purpose and role of spirituality in the rehabilitation centre. The rest of the interview questions were about challenge of practicing, feeling and impact of spirituality in their lives.
Data collection procedures
Before starting the interview process, the researchers introduced the purpose of the study, and prepared an interview timetable with consent from each participant.
Then, each of the individuals were interviewed in a group discussion and trusting atmosphere, which was believed to result in reliable and comprehensive data. All interviews were tape-recorded during discussion, it was lasted about 45 min.
Data analysis
In the present study, the qualitative data analysis process was carried in four steps (see Fig. 2). The recorded interviews were firstly transcribed verbatim. Then, in order to ensure reliability of the data, one randomly selected transcript was coded by three educational specialists independently. Nearly all of the codes that emerged were consistent. This process ensured reliability among the coders, or otherwise known as inter-rater reliability. The analysis of data uses inductive analysis and creative synthesis. The researchers began by exploring, then confirming, guided by analytical principles rather than rules, and ending with a creative synthesis.
Figure 2 summarizes the procedure of data analysis in this study.
Figure 2. Data Analysis Process
In data analysis, the researchers followed the procedures similar to Schloss and Smith’s six stages approach. The tape-recorder interview (Stage 1) was transcribed using software (Express Scribe). The transcriptions procedures (Stage 2) for an informant took 72 hours. Thus, the researchers focused on words as the basic medium
•Transcribing the interview verbatim
Transcription
•Coding the interview
•Revising the codes
•Constructing code list
Data Coding
•Investigating common aspect of the codes
•Constructing themes
& categories Theme &
Categories
•Using codes and quotation together
•Interpreting the results
Result &
Interpretation
in the data analysis. The researchers focused to answer four research questions by using transcribed data with assigned discourse units as quick references, the researchers proceeded to write the narrative forms of the cases in Stage 3. Following this segment, the narrative history of participants and the findings which encompassed the analytic strategies for coding and synthesising data, were developed.
D. Finding and Discussion Findings
Can spirituality help addict in the recovery process? This research reveals that Islamic spirituality has a great influence for healing process of addicts to restore the physical, psychological, mental and spiritual conditions. Nonetheless, this healing process makes a gradual change over a duration of time, which also requires a lot of effort and perseverance because the level of addiction is very complex and diverse involving all aspects of individual life (i.e., physically, mentally, psychologically, socially and spiritually). Surely, it needs a strong intention and determination, patience, discipline and sincerity to succeed in the healing programme until most of the symptoms disappear, especially the impulses for drug use and abuse.
Interestingly, the conditions that are needed in the rehabilitation process of addicts are available in the psycho-spiritual dimensions of Islamic spirituality. This study concludes that Islamic spirituality dimensions have specific characteristics regarding therapy approach which certainly gives a very powerful driving force of drug use cessation. The first dimension shows that faith (tauheed) has a role for establish the optimistic feelings and inner strength to improve the mentality and psychological conditions in order to stay away from drug use and to get a better life.
The second dimension, spiritual-intellectual, develops a strong intention and determination to leave all the bad things in the past and to become better in the future.
The third dimension, Ritual Ibadah, gives a positive influence in personality such as feelings of optimism, peace of mind, self-control, a better self-image, and emergence of a tendency to always do good deeds and obedience in life. The final dimension, socio-spiritual, has considerable impact on individual personality such as feeling patient, open minded and having the will to undergo a rehab process, see the positive things in life, and feel grateful to God. In short, Islam emphasizes the faith and ritual worships as well as good characters (akhlak) among others, good words and virtues such as patience or reliability, and encourages the good and prohibits the evil doings.
Furthermore, in answering the questions in this study, the researchers categorised the findings into four dimensions in accordance with Islamic psycho- spiritual dimensions namely the creed (tauheed), intellectual, ritual (ibadah) and social.
Tauheed Dimension: Reflective Feeling
Spirituality has a profound impact to self-awareness on the past mistakes and errors that continuously made them repent to Allah the Almighty. Along with studying and understanding the Islamic aqidah that is conducted regularly at the centre, the respondents have been able to change their perspective on the spirituality and they can feel their inner spirit heal itself from its previous weakness and mistakes. But
since their conditions are still weak physically and mentally, this impact of spirituality cannot dramatically modify their personality. They have just begun to recognize the concept of God (Tauheed) in the right way and understand the concept of Islamic teaching for peace, safety, and security in their life, so they begin to feel the harmony or balance between their real life and expectations. P1 said,
“Actually, it is depending on the person, for me with zikr and prayers; From my experience, the spiritual practices make me more religious and more motivated to my therapy process… I don’t want to be like my previous condition, I want to make my parent proud to me, and I want to be a success in my life….”
After undergoing the process of recovery (usually at least 2 weeks until 1 month), their understanding on spirituality got better accompanied with increasing the quality of their life and awareness. They could strengthen their physical, psychological and mental conditions to become free from drugs. With this concept of Tauheed, they revealed that they really felt a strong motivation to leave all the bad and destructive activities in their lives especially drugs habit and delinquency. P4 said,
“I think because I felt that by knowing the religion was very little…so I have to be able to practice and learn more seriously, because I think the spirituality can help me a lot to improve my life, in a way actually to get closer to Allah Ta’ala. I really want to make change in my life with continuing my practices in the spirituality such as dzikir and prayers….”
Therefore, the researchers conclude that the influence of spirituality on the process of recovery as a reflective impact is associated with the deep awareness to repent to Allah and revive their life with good deeds and actions.
Intellectual Dimension: Insight Awareness
According to the analysis, spirituality can develop a strong intention and determination to leave all the bad things behind and to become better in the future.
The respondents admitted that they felt confident to face the difficulties and challenges during the healing process although it took long time to do so in the centre.
The researchers referred to this spiritual influence as the healing process in the form of insight awareness that functions to avoid various temptations and tendencies within themselves, and then they can continue to perform spiritual activities regularly.
P1 said,
“From what I understand about spirituality is a part, compulsory part of human life, especially Islam when teach all about practical within one life, with human relationship other human and also relation human and God… I felt that spirituality can make me the better person….”
The respondents also added that the insight awareness is very beneficial to them in order to live with all spiritual activities as a primary healing process at the centre.
Gradually, they felt easier to perform spiritual obligations and they considered it as their own activities in the life. This is because they have understood the usefulness of various Islamic spiritual concepts for themselves. For example, they understood that the Islamic spiritual practices are important in to ensure their lives are guided to the right way. In addition, they also understood that the Islamic teachings are directly beneficial to their lives after they performed prayers and dzikr with tranquillity and peace in their lives.
P4 said,
“Since am here, for me spirituality is very important because it is actually has many activities related to God awareness, such as Dzikr, prayer, fasting, and others…..actually it will develop our self…”
Therefore, the programme set by the therapist at the centre for recovery addicts, runs faster with credible impact to the patients since they have an insight awareness to change their lives and to become a good person.
Ritual Ibadah Dimension: Expression Attitude
Furthermore, according to the respondents after they had performed Islamic spiritual activities regularly and continuously in their lives, they got a positive influence in their personality. Clearly, they agreed that these ritual activities made them feel optimistic, having peace of mind, self-control, a better self-image and emergence of a tendency to always do good deeds and be obedient in their lives.
P2 said,
“From spirituality I become motivated and it’s not just my practice in Islam but also my behaviour as well. I really do not want to repeat my mistakes for the second time…I want to continue my study to make my parent happy to me... I more optimistic, peace of mind, and able to control myself .”
They explained that a feeling of optimism appeared after they realized the right path in their lives, so they could feel confident when performing ritual ibadah without any anxiety and worry in their hearts. In addition, with the implementation of the ritual ibadah, they could distinguish between the truth and evil that also helped them to control themselves when the bad impulses come to their minds. And also, with performing ibadah, they were more aware and obedient with all the practices in Islam regarding good and bad in the society.
P1 said,
“…then we take some rest until 10.30 am, after 11 am we must get up to taking bath and prepared our self to perform dhuhur prayer, then reciting dzikir for almost half an hour before we take our lunch…in the afternoon session, we have to perform prayer and reciting dzikir until before we sleep. But for me…the most dominant effected to me was dzikr and taking bath in early morning….”
Also, P2 said,
“I learn from essence of Islam from basic things such as reading Qur’an, perform prayers, and fasting… basically I have manage to be more pious and active in religious or spiritual activities, then…I have learn to differentiate between good and bad.”
Moreover, the researchers labeled this influence of spirituality as expression attitude that explains the optimistic feeling, peace of mind, self-control, the image of goodness and their obedience in the rehabilitation centre. This process serves as a way to establish a stronger mentality that encourages them to do good behaviours and practice positive attitudes in their lives.
Social Dimension: Brightness Image
In the social dimension, the spiritual aspect has a considerable impact on their personalities when they interact with the environment around the centre, families and society in general. Although their image as an addict cannot be directly eliminated, but they are still trying to be accept this label even though it was hard for them. With patience, they kept an open mind and heart so they could maintain the will to undergo the rehab process and continue to perform spiritual activities in the centre. In addition, they tried to see the positive side of the events in their lives, so they could feel grateful for the various pleasures and gifts from God to them, especially the opportunity to improve their lives until now. Therefore, with spiritual activities they became more grateful and optimistic in becoming a better person in the future after they finished the recovery process. P2 said,
“For me environment in the centre has influenced myself to improve my spirituality, but I think it very hard for this practice of spirituality….but I has a regret feeling to not going back with my past and I need to focus with my study….”
P3 also mentioned that,
“..the environment is good for me but still I need to adjust my spirituality since it was very difficult for me to follow all the ritual activities….i think it will become my habit in the future and really I feel more healthy….”
The researchers then labelled this influence as the brightness image that includes the nature patience, gratitude and diligence in worship. With a personality with these attitudes, they become open minded and relaxed with all good activities in their lives so that they would be able to maintain and continue this ability after completing the rehabilitation process. In addition, they would be able to adapt in the environment by keeping busy with their daily worships and good deeds, so that they can avoid the risk of relapse.
Table 2 summarizes the findings of this study including the generated themes and therapy aspects for drug addicts.
Table 2.
Generated themes and therapy aspects Participant
Themes
Evidence Therapy Aspect Reflective
Feeling (RF)
Insight Awareness
(IA)
Expressive Attitude
(EA)
Brightness Image
(BI) P1
Regret
feeling Feeling of istiqamah (consistency)
optimistic
feeling Attitude of patience
“Spirituality can make me the better person”
Realizing the mistakes and errors in the past (regret feeling)
P2
Aware of mistakes and errors
Power of
self peace of
mind Gratitude “I become motivated and I manage to
Improving self-concept to make changing in life from
improve
myself” bad to good actions
P3
Spiritual
awareness Consistent
in worship self-
control Focus on
worships “Spirituality make me feel consistent in worshiping Allah”
Becoming independent, confident, and obedient in life
P4
Peace in
life Feeling of submissive to God
good image and obedience
Diligent in
worship “Spirituality does impact in the study to excel the study”
Becoming aware on life’s responsibilities, independent, and confident Discussion
From this study, the researchers conclude that Islamic therapy has a significant influence in the healing process of addicts. In ceasing drug-use, all dimensions of Islamic spirituality (i.e., transcendence/tauheed, intellectual, ritual worships, and social) have given the respondents deeper meaning in their life. The first dimension, transcendence/tauheed gives a self-awareness on the past mistakes and errors that continuously make them repent to Allah the Almighty. This feeling become the starting point for therapy process in the Centre of Spiritual therapy since the Islamic spirituality places great emphasis on reflection, train people who have insights, behave properly, which portrays the faith to God (tauheed).
This tauheed is also related to fitrah of human’s life because according to Islamic teachings, all the humans are created to worship Allah Ta’ala as the only One Creator in the universe. Islam is a religion that is fitrah. The main purpose of knowing human nature is to understand humanity itself. The concept of the fitrah related to values, such as justice, mercy, patience, sacrifice, obedience, generosity, helpfulness, forgiveness, trust and so forth, constituting the character of an individual and his or her relationship with his or her Creator and the society as mention in Al-Qur’an.
“So be steadfast in faith in all uprightness O Prophet—the natural Way of Allah which He has instilled in all people. Let there be no change in this creation of Allah. That is the Straight Way, but most people do not know” (Surah Ar Rum :30)
In addition, the process of spiritual therapy means that the establishment of a healthy psycho-spiritual equilibrium is a person’s control of the worldly tendencies of nafs (desire) and the spiritual tendencies of ruh (soul). Spirituality is humanity portrayed as a way of life. This makes the Islamic view of human nature a holistic one, as it integrates the physical and the psychical aspects with the spiritual aspect. The researchers generate this influence of this dimension as reflective feeling. The second dimension spiritual-intellectual, has developed a strong intention and determination to leave all the bad things in the past and to become better in the future. Basically, Islamic psychotherapy is reflective, directive and critically supportive. Thus, psychotherapists should regard it as their professional and moral duty to remove the
confusion in their clients about spiritual and moral values and to enable them to perceive credible impact to change their life and to be a good person. The researchers generate the influence of this dimension as insight awareness. One of the roles of psychologist is to help fellow human beings. Al amru bil-almaruf wa an nahyu an al munkar becomes the main core in one's actions in Islam. Human beings are directed to the good and stay away from the bad or sin. The help given by the psychologist is not directed to matters that harm others.
The third dimension, Ritual Ibadah, gives a positive influence in the personality such as optimistic feelings, peace of mind, self-control, a better self-image and emergence of a tendency to always do good deeds and be obedient in life. The researchers labelled this influence of this dimension as expression attitude. The Qur’an has described the importance of having intention to worship and consistency in doing so toward psychological, mental, and spiritual conditions.
“Recite what is revealed to you of the Scripture, and perform the prayer. The prayer prevents indecencies and evils. And the remembrance of God is greater. And God knows what you do”
(Al Ankabut, 29:45)
The final dimension, socio-spiritual, has considerable impact on individual personality such as feeling patient, open minded and keeping the will to undergo a rehab process, see the positive things in life and feel grateful to God.21 In other words, Islam emphasizes the faith and ritual worships as well as good character (akhlak) among others, good words and virtues such as patience, reliability, and encourages the good and prohibits the bad. According to Fadzli Adam, Wan Ibrahim, and Wan Ahmad, “Spiritual and Traditional Rehabilitation Modality of Drug Addiction in Malaysia” 1, no. 14 (2011): 175–81., this spiritual therapy adopted two significant aspects which are psychosocial and ”tough and rugged”. This, socio-spiritual is aimed to build physical endurance, self-discipline and mentality. Therefore, this rehabilitation process includes physical rehabilitation, psychological, vocational, self- discipline, religious, civic, family, community and recreation. The researchers categorised the influence of this dimension as brightness image that includes the natural patience, gratitude and diligence in worship.
The psycho-therapy model based on the Islamic teaching demonstrate the therapeutic interventions. Thus, it appears to reorienting the western paradigm of psycho-therapy with meaningful Islamic knowledge, theories and parameters.
Moreover, convince that psycho-therapist who is operating within an Islamic paradigm, differs significantly from that of a conventional psycho-therapist is that the inner world they are inviting the patient to explore is not limited to human consciousness through mental processes and cognition, but it is a holistic picture of the human being that very much involves the exploration of its metaphysical essence.
Thus, in developing a psycho-therapy model and framework for Muslim, it is essential to include all aspect of competencies that can serve its own identity. The primary competencies include skills, training, values, internal character traits and Islamic education.
21 Adam, Ibrahim, and Ahmad, “Spiritual and Traditional Rehabilitation Modality of Drug Addiction in Malaysia.”
E. Conclusion
In summary, this study has explored the understanding and practicing of adolescent spirituality in the rehabilitation centre as the main source of therapy. It has portrayed the direct impact of practicing spirituality towards changing the behaviour of adolescents who have a problem with mental illness. Spirituality has interrelated factors, i.e., aqidah (beliefs), ibadah (practices of ritual), and intellectual, and social (morality) which become key important factors of Islamic Psycho-therapy toward mental illness.
The four dimensions are explored in this study namely, reflective feeling (RF), insight awareness (IA), expressive attitude (EA), and brightness image (BI) are the generated themes to explain the influence of Islamic psycho-therapy to recover addiction.
The stages of interventions in the study have shown some techniques and skills used by the therapist to incorporate the western qualities imbued with Islamic teaching and values in the interventions. Each stages required proper skills and techniques to improve spiritual, psychological, physical and mental well-beings with local flavors. Perhaps further enhancement on the healing process for drug addiction such as intervention and treatment adapting Islamic teaching and values will create better awareness of mental health issues at the local societal level. As in academia, additional efforts should be given to the theoretical formulation and strategies to discover the Islamic positions and world views on intervention and treatment for drug abuse and addictions. That much of the current work on psycho-therapy tend to focus on general Islamic themes and concepts, rather than a more comprehensive formulation of human psyche. In the researchers point of views, such efforts can be achieved through inter discipline studies and ongoing endeavors.
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